肩部钙化性肌腱炎(RCCT)是由于钙化物质在关节周围的肌腱中沉积,刺激肌腱并导致其柔韧性下降及炎症反复发作的非创伤性肩部疾病。其确切的发病机制目前尚未完全明确。RCCT在中医学中属于“痹症”等范畴,中医对肩痹疼痛的研究历史悠久。目前,针对肩袖钙化性肌腱炎的治疗方法尚未形成统一的标准,中西医治疗各有其优势。鉴于本病具有自限性特点,保守治疗和微创治疗成为首选方案,对于那些经过保守治疗无效的RCCT患者,最终可能需要采取手术治疗。本文旨在探讨肩袖钙化性肌腱炎的中西医诊疗策略。Rotator cuff calcific tendonitis (RCCT) is a non-traumatic shoulder disease caused by the deposition of calcified substances in the tendons around the joint, which stimulates the tendons and leads to a decrease in flexibility and recurrent inflammation. The exact pathogenesis is currently not fully understood. RCCT belongs to the category of “bi syndrome” in traditional Chinese medicine, and the research history of shoulder bi pain in traditional Chinese medicine is long. At present, there is no unified standard for the treatment of calcified tendinitis of the rotator cuff, and both traditional Chinese and Western medicine have their own advantages in treatment. Given the self-limiting nature of this disease, conservative and minimally invasive treatments have become the preferred options. For RCCT patients who have failed conservative treatment, surgical intervention may ultimately be necessary. This article aims to explore the diagnosis and treatment strategies of calcified tendinitis of the rotator cuff using both traditional Chinese and Western medicine.
目的横断面研究血清尿酸(serum uric acid,sUA)与高密度脂蛋白胆固醇(high density lipoprotein-cholesterol,HDL-C)比值(sUA to HDL-C ratio,UHR)与女性不孕之间的关系。方法分析来自美国国家健康与营养调查(National Health and Nutri...
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目的横断面研究血清尿酸(serum uric acid,sUA)与高密度脂蛋白胆固醇(high density lipoprotein-cholesterol,HDL-C)比值(sUA to HDL-C ratio,UHR)与女性不孕之间的关系。方法分析来自美国国家健康与营养调查(National Health and Nutrition Examination Survey,NHANES)数据库中2013~2018年2963例年龄在18~45岁之间的女性参与者。使用多变量逻辑回归模型评估UHR与不孕症之间的关联性,调整多种混杂因素,通过亚组分析和限制性立方样条(restricted cubic spline,RCS)模型探讨其相互作用和剂量反应关系,利用受试者工作特征(receiver operating characteristics,ROC)曲线分析评估UHR对不孕症的预测价值。结果不孕症女性的基线UHR(9.68±4.23)显著高于未患不孕症的女性(8.7±3.81,P<0.001)。多变量逻辑回归分析显示,UHR处于最高四分位数(Q4)的女性与最低四分位数(Q1)相比,患不孕症的概率显著增加。不同模型中调整后的OR范围为1.61(95%CI:1.14~2.28)到1.98(95%CI:1.42~2.78)(趋势P<0.001)。亚组分析显示,这些关联在不同年龄组、体质量指数(body mass index,BMI)和种族群体中具有一致性。RCS模型显示,UHR与不孕症风险之间存在显著的线性剂量-反应关系(非线性P=0.03,总体关联P<0.001)。ROC分析表明,UHR在预测女性不孕状态方面具有中等能力,其曲线下面积(area under the curve,AUC)为0.570。结论较高的UHR与女性不孕风险增加显著相关,UHR具有作为女性不孕症风险预测生物标志物的潜力。
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